Abstract Background Tissue adhesive, adhesive tape, and sutures are used to close surgical incisions. However, it is unclear which produces the best results in children, and whether combination wound closure is better than sutures alone. Methods In this parallel randomised controlled trial (ANZCTR: ACTRN12617000158369), children (aged 18 years or less) undergoing elective general surgical or urological procedures were randomized to skin closure with sutures alone, sutures and adhesive tape, or sutures and tissue adhesive. Participants were assessed 2 weeks, 6 weeks, and more than 6 months after operation. Outcomes included wound cosmesis (clinician- and parent-rated) assessed using four validated scales, parental satisfaction, and wound complication rates. Results 295 patients (333 wounds) were recruited and 277 patients (314 wounds) were included in the analysis. Tissue adhesive wounds had poorer cosmesis at 6 weeks: median 10-point VAS score 7.7 with sutures alone, 7.5 with adhesive tape, and 7.0 with tissue adhesive (P = 0.014). Respective median scores on a 100-point VAS were 80.0, 77.2, and 73.8 (P = 0.010). This difference was not sustained at over 6 months. There was no difference in parent-rated wound cosmesis at 6 weeks (P = 0.690) and more than 6 months (P = 0.167): median score 9.0 with sutures alone, 10.0 with adhesive tape, and 10.0 with tissue adhesive at both stages. Parental satisfaction was similar at all points, with a median score of 5 (very satisfied) for all groups. There was one instance of wound dehiscence in the tissue adhesive group and no wound infections. Conclusion Short-term wound cosmesis was poorer with tissue adhesive although it is unclear whether this difference is sustained in the long-term. There were no differences between techniques for the study outcomes. Registration number ACTRN12617000158369 (ANZCTR) (https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372177&isReview=true).

中文翻译：

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用于儿童手术伤口皮肤闭合的组织粘合剂、胶带和缝合线：前瞻性随机临床试验

摘要 背景组织粘合剂、胶带和缝线用于闭合手术切口。然而，尚不清楚哪种方法对儿童效果最好，也不清楚联合伤口闭合是否比单独缝合更好。 方法在这项平行随机对照试验 (ANZCTR: ACTRN12617000158369) 中，接受选择性普通外科或泌尿外科手术的儿童（18 岁或以下）被随机分配至仅使用缝合线、缝合线和胶带或缝合线和组织粘合剂进行皮肤闭合。参与者在术后 2 周、6 周和 6 个月以上接受评估。结果包括使用四种经过验证的量表评估的伤口美容（临床医生和家长评分）、家长满意度和伤口并发症发生率。 结果招募了 295 名患者（333 处伤口），其中 277 名患者（314 处伤口）纳入分析。组织粘连伤口在 6 周时美观性较差：单独缝合时的中位 10 点 VAS 评分为 7.7，使用胶带时为 7.5，使用组织粘合剂时为 7.0（P = 0.014）。100 分 VAS 的中位数分别为 80.0、77.2 和 73.8 (P = 0.010)。这种差异没有持续超过 6 个月。6 周（P = 0.690）和 6 个月以上（P = 0.167）时，家长评价的伤口美容没有差异：两个阶段仅缝合的中位分数为 9.0，使用胶带的中位分数为 10.0，使用组织粘合剂的中位分数为 10.0。家长的满意度在所有方面都相似，所有组的中位数均为 5 分（非常满意）。组织粘合剂组有1例伤口裂开，无伤口感染。 结论组织粘合剂的短期伤口美容效果较差，但尚不清楚这种差异是否会长期持续。研究结果的技术之间没有差异。 注册号码ACTRN12617000158369 (ANZCTR) (https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372177&isReview=true)。